Swallow Syncope: A Case Report and Review of the Literature

Abstract

Swallow or deglutition syncope is a relatively rare syndrome. It is vagally mediated syncope induced by swallowing. Swallow syncope may occur at all age groups and is treatable when diagnosed. A 60-year-old woman presented with an episode of syncopal attack associated with swallowing a sandwich. She had a 6-month history of recurrent episodes of lightheadedness while eating solid foods. Telemetry monitoring demonstrated several episodes of severe bradycardia and complete atrioventricular (AV) block with up to 7.0 seconds pause associated with meals. Computed tomography of head and neck revealed no significant findings and barium esophagram was normal. Echocardiogram was within normal limits. Her symptoms resolved after permanent pacemaker placement. We review the diagnosis, mechanism and management of swallow syncope.